Related Experiment Video
Updated: Jul 27, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Aortic valve replacement and long-term prognosis
Abdelouahed Naslafkih1, Sestier François, Jean-Marc Fix
1Université de Montréal, Insurance Medicine Program, CP 6128 Succ, Centre-ville, Montreal, QC, Canada H3C 3J7.
Objective:
We assessed the long-term risk of mortality associated with mechanical and biological aortic valve replacement (AVR).
Methods:
We reviewed articles published during the last decade, with emphasis on large series reporting mortality data and follow up of 5 years or longer. The latest editions of textbooks on cardiology and cardiac surgery were also reviewed. We used mortality analysis methodology, comparing the observed mortality in these series to the expected mortality calculated from country specific life tables, to calculate the risk of mortality expressed as the mortality ratio (MR), values above 100% traducing the excess risk of mortality compared to the general population.
Results:
After AVR, the MR varied from 120% to 350% for mechanical valve prostheses, and from 100% to 300 for bioprosthetic valves according to age at surgery. MR above 400% was associated with an AVR before the age of 50 years. No significant difference in the MR over age 50 years was found between mechanical and biological AVR. Independent prognostic factors after AVR are age at surgery, New York Heart Association (NYHA) functional class at time of surgery, left ventricular ejection fraction (LVEF), atrial fibrillation, and type and severity of valvular lesion.
Conclusion:
No difference was found for excess mortality between mechanical and biological AVR. Under the age of 50 years, higher mortality was associated with both mechanical and bioprosthetic AVR.
More Related Videos
Related Concept Videos
Mitral Stenosis III: Medical Management
Aortic Regurgitation I: Introduction
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation III: Medical Management
Aortic Regurgitation IV: Nursing Management
Cardiomyopathy V: Interprofessional Care

